Quality of life considerations frequently are factors in medical management decisions for geriatric patients, especially those with chronic diseases. Physicians and patients may differ in the values they attribute to components of quality of life. Similarly, a patient and his spouse may differ in the values they attribute to components of the patient's quality of life. This analytical-observation study will compare physician, geriatric patient and spousal attitudes about quality of life. This will help elucidate the relevant considerations in selecting therapeutic end-points for elderly patients. It also will provide insight into the general capability of spouses to serve accurately as clinical decision makers for their conjugal partners. Questionnaires will be administered to approximately 70 academic and community physicians of ambulatory geriatric care, 20 physicians with major nursing home responsibilities, and 350 randomly selected geriatric patients and their spouses (approximately 130). For each patient, physicians will identify and describe 2 types of actions they took in the preceding year, those that improved and those that diminished their patient's quality of life. Other questions will concern qualities and values attributed to life. A similar questionnaire will be administered to the patients and their spouses. The results of this study are intended to benefit elderly patients. The project will describe the affects of medical care on quality of life and the dimensions of quality of life considered important by patients. The results will document the degree to which physicians can identify the quality of life dimensions considered important by their patients. The results will assist clinicians in determining what is beneficial for elderly patients, and what constitutes appropriate therapeutic goals. The project also will document the degree to which spouses can report accurately the values of their husbands/wives. This information may be useful when the patient cannot communicate. This study will expand basic knowledge about the dimensions of quality of life in elderly patients and the role of quality of life in medical decision-making for these patients.